Fig. 6. Graph representing new bone and composite bone percentages within the elevated area
Fig. 6. Graph representing new bone and composite bone percentages within the elevated area
Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found
Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found
Fig. 4. Photomicrographs of ground sections after 4 months of healing. a Bone formed from the base of the sinus. b Bone plate connected by bridges of the new bone to the close-to-window region. c Particle of the graft surrounded by new bone. d Overexposed image to show the new bone ingrowth within the granules of biomaterial
Fig. 4. Photomicrographs of ground sections after 4 months of he...
Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal
Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal
Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire was placed. c The elevated sinus was grafted. d The access bony window was repositioned and secured with cyanoacrylate
Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire wa...
Fig. 1. Clinical view at a membrane site. a Skin and periosteum were separately elevated, and the facial sinus wall exposed. b A 12 × 8-mm window was cut and removed. c The Schneiderian membrane was carefully elevated. d A twisted wire was inserted in the middle of the long side of the window and the elevated sinus was grafted. e At the control site, a resorbable membrane was placed and secured...
BoneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowCenter61.5 ± 46.982.5 (22.2; 96.9)21.7 ± 22.6*17.5 (3.1; 34.4)2.3 ± 4.3*0.0 (0.0; 2.3)7.9 ± 19.30.0 (0.0; 0.0)69.3 ± 38.582.5 (57.6; 96.9)Edge37.2 ± 37.021.6 (16.8; 55.8)41.0 ± 39.833.6 (9.2; 64.9)5.3 ± 7.31.6 (0.0; 9.1)13.8 ± 19.0*6.7 (0.0; 19.7)54.8 ± 34.162.9 (37.5; 69.7)MembraneCenter5.8 ± 2.1 (P = 0.116)5....
New boneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowTotal16.4 ± 5.618.8 (13.8; 20.3)32.9 ± 8.031.2 (27.7; 37.0)13.6 ± 4.212.0 (10.8; 16.2)37.1 ± 7.534.4 (31.7; 43.4)53.5 ± 7.652.4 (50.8; 57.8)Base15.0 ± 7.216.4 (10.1; 20.1)38.6 ± 14.334.5 (28.9; 47.1)13.4 ± 6.415.3 (13.1; 17.0)33.1 ± 11.133.1 (26.8; 40.0)48.0 ± 18.149.9 (36.9; 59.7)Middle16.9 ± 7.318.1 (11.2...
Perini, A., Ferrante, G., Sivolella, S. et al. Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep. Int J Implant Dent 6, 11 (2020). https://doi.org/10.1186/s40729-020-0207-1
Download citation
Received: 01 October 2019
Accepted: 04 February 2020
Published: 18 March 2020
DOI: https://doi.org/10.1186/s40729-020-0207-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013).
All the authors consent to publication.
Alessandro Perini, Giada Ferrante, Stefano Sivolella, Joaquín Urbizo Velez, Franco Bengazi, and Daniele Botticelli declare that they have no competing interests.
Correspondence to Alessandro Perini.
Department of Neuroscience, Division of Dentistry, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
Alessandro Perini, Giada Ferrante & Stefano Sivolella
Faculty of Dentistry, University of Medical Science, Havana, Cuba
Joaquín Urbizo Velez & Franco Bengazi
ARDEC Academy, Ariminum Odontologica, Rimini, Italy
Daniele Botticelli
You can also search for this author in
...
This study was funded by ARDEC Academy, Ariminum Odontologica s.r.l., Rimini, Italy.
Degradable Solutions AG, a Sunstar Group Company, CH-8952 Schlieren ZH, Switzerland, provided free of charge the biomaterials used.
Iida T. Carneiro Martins Neto E, Botticelli D, Apaza Alccayhuaman KA, Lang NP, Xavier SP. Influence of a collagen membrane positioned subjacent the sinus mucosa following the elevation of the maxillary sinus: a histomorphometric study in rabbits. Clin Oral Implants Res. 2017 Dec;28(12):1567–76.
Inal S, Yilmaz N, Nisbet C, Güvenç T. Biochemical and histopathological findings of N-butyl-2-cyano...
Russell WMS, Burch RL. The principles of human experimental technique. London: Methuen; 1959.
Schroeder HE, Münzel-Pedrazzoli S. Correlated morphometric and biochemical analysis of gingival tissue: morphometric model, tissue sampling and test of stereologic procedures. J Microsc. 1973 Dec;99(3):301–29.
Sohn DS, Kim WS, An KM, Song KJ, Lee JM, Mun YS. Comparative histomorphometric analysis of ...
Nosaka Y, Nosaka H, Arai Y. Complications of postoperative swelling of the maxillary sinus membrane after sinus floor augmentation. J Oral Sci Rehab. 2015;1:26–33.
Tawil G, Tawil P, Khairallah A. Sinus floor elevation using the lateral approach and bone window repositioning I: clinical and radiographic results in 102 consecutively treated patients followed from 1 to 5 years. Int J Oral Maxillof...
Tatum H Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler DG, Johnson PW, Lozada JL, Misch C, Rosenlicht JL, Tatum OH Jr., Wagner JR. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36:151–86.
Boyne PJ, James RA. Grafting of the ...
Biphasic calcium phosphate
Deproteinized Bovine Bone Mineral
Hydroxyapatite
Infraorbital nerve canal
Standard deviation
Beta-tricalcium phosphate
All data and materials are available for control and consultation contacting the first author (alexperini@studioschweiger.it).
In conclusion, the repositioning of the bone window after sinus floor elevation in sheep, compared with the use of a resorbable membrane, improved the closure of the antrostomy and led to a greater amount of the newly formed bone in the close-to-window zone of the grafted area. The bone window appeared partially bonded to the newly formed bone. Bridges of new bone from the edges of the antrostomy ...
In the present study, a lesser amount of bone was registered subjacent to the sinus mucosa compared with the other regions. This is in agreement with another experiment, in which a similar material was used for sinus augmentation in sheep [24]. A similar outcome was also reported in another study [27] that used DBBM xenograft for sinus augmentation in sheep. In that study, a collagen membrane was ...
In another similar experiment in sheep, the sinuses were augmented using a similar biphasic calcium phosphate (60% HA, 40% β-TCP) [24], the biomaterial used in the present study. The perforation of the sinus mucosa was performed at the test sites and a collagen membrane was placed to protect the perforation, while at control sites the elevated mucosa was left unprotected. After 12 weeks of heal...
The aim of the present study was to compare the healing of the augmented sinus in large animals, where the antrostomy was covered by a polylactic membrane or a repositioned bone plate, both secured with cyanoacrylate.
No statistically significant differences were found between test and control sites in the bone formation within the augmented space. This outcome is in agreement with a similar stud...
In the centre of the window area, at the test sites, in the analysed histological sections, the bone plate was still visible in five out of six sheep. It appeared partly remodelled and connected by the new bone formed in the sub-window area. Out of the five bone plates still present, three were bridged to the edges of the antrostomy, while in the two cases no contact was achieved in the observed s...
During surgery, one sheep showed acute sinusitis at the test site. The sinus mucosa was perforated to allow sinus drainage and surgery was completed. During the healing period, no evident clinical complications were observed.
At the histomorphometric analysis, one sinus of the control group and one of the test group (corresponding to the sinusitis case) appeared to have lost almost all biomateria...
The percentages of the new mineralised bone, soft or connective tissue, pure graft, graft interpenetrated by bone, and remnants of cyanoacrylate were evaluated. The total tissue percentages in the elevated space that included submucosa, middle, base, and sub-window regions were also calculated.
Mean values and standard deviations (SDs) as well as the 25th, 50th (median), and 75th percentiles were...
After 4 months, the animals were anaesthetised and then euthanised with an overdose of pentobarbital sodium and subsequently perfused with 10% formalin. The maxilla was retrieved en bloc, trimmed, and immersed in formalin solution.
All histological procedures were performed in the Laboratorio de Histologıa de la Facultad de Odontologıa de la Universidad de Ciencia Medica in Havana, Cuba. Bila...
Through an extra-oral approach, an oblique incision was made bilaterally along the sagittal axis between the facial tuberosity and the inferior orbital rim. The skin and periosteum were elevated separately, and the bony facial sinus wall was exposed on both sides of the maxilla (Fig. 1a).
A 12-mm large and 8-mm high antrostomy was prepared using a burr (H254E Komet Dental, Trophagener Weg 25, L...
The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013).
Eight female Pelibuey sheep, with a mean body weight of approximately 35 kg and a mean age of approximately 3 years, were provided by the Centro Nacional para la Producción de Animales de Laboratorio (CENPALAB) in Havana, Cuba...
To prevent the movement of the bony plate and to gain adequate stability, cyanoacrylate has been suggested to glue the plate to the bony edges of the antrostomy [17]. Cyanoacrylates (as methyl 2-cyanoacrylate or ethyl 2-cyanoacrylate) are widely used in surgery and have shown good compatibility [18] and biomechanical strength for fixation of grafts [19]. In an experiment in rabbits [17], the antro...
Sinus floor elevation is a commonly used technique to increase bone volume in the posterior maxilla prior to implant placement. This procedure was first developed by Tatum in 1977 [1], modified by Boyne and James in 1980 [2], and further modified over time. In this well-described technique, a bony window is created on the lateral wall of the sinus with a round burr, and the membrane elevated. Diff...
The objective of this study was to compare the healing of the augmented sinus at which the antrostomy was covered with a membrane or the repositioned bone plate.
Eight sheep underwent bilateral maxillary sinus floor augmentation. The control site was covered with a resorbable membrane, while at the experimental site the bone plate was repositioned, and both were secured with cyanoacrylate. Animal...
Fig. 6. Graph representing new bone and composite bone percentages within the elevated area
Fig. 6. Graph representing new bone and composite bone percentages within the elevated area
Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found
Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found
Fig. 4. Photomicrographs of ground sections after 4 months of healing. a Bone formed from the base of the sinus. b Bone plate connected by bridges of the new bone to the close-to-window region. c Particle of the graft surrounded by new bone. d Overexposed image to show the new bone ingrowth within the granules of biomaterial
Fig. 4. Photomicrographs of ground sections after 4 months of he...
Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal
Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal
Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire was placed. c The elevated sinus was grafted. d The access bony window was repositioned and secured with cyanoacrylate
Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire wa...
Fig. 1. Clinical view at a membrane site. a Skin and periosteum were separately elevated, and the facial sinus wall exposed. b A 12 × 8-mm window was cut and removed. c The Schneiderian membrane was carefully elevated. d A twisted wire was inserted in the middle of the long side of the window and the elevated sinus was grafted. e At the control site, a resorbable membrane was placed and secured...
BoneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowCenter61.5 ± 46.982.5 (22.2; 96.9)21.7 ± 22.6*17.5 (3.1; 34.4)2.3 ± 4.3*0.0 (0.0; 2.3)7.9 ± 19.30.0 (0.0; 0.0)69.3 ± 38.582.5 (57.6; 96.9)Edge37.2 ± 37.021.6 (16.8; 55.8)41.0 ± 39.833.6 (9.2; 64.9)5.3 ± 7.31.6 (0.0; 9.1)13.8 ± 19.0*6.7 (0.0; 19.7)54.8 ± 34.162.9 (37.5; 69.7)MembraneCenter5.8 ± 2.1 (P = 0.116)5....
New boneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowTotal16.4 ± 5.618.8 (13.8; 20.3)32.9 ± 8.031.2 (27.7; 37.0)13.6 ± 4.212.0 (10.8; 16.2)37.1 ± 7.534.4 (31.7; 43.4)53.5 ± 7.652.4 (50.8; 57.8)Base15.0 ± 7.216.4 (10.1; 20.1)38.6 ± 14.334.5 (28.9; 47.1)13.4 ± 6.415.3 (13.1; 17.0)33.1 ± 11.133.1 (26.8; 40.0)48.0 ± 18.149.9 (36.9; 59.7)Middle16.9 ± 7.318.1 (11.2...
Perini, A., Ferrante, G., Sivolella, S. et al. Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep.
Int J Implant Dent 6, 11 (2020). https://doi.org/10.1186/s40729-020-0207-1
Download citation
Received: 01 October 2019
Accepted: 04 February 2020
Published: 18 March 2020
DOI: https://doi.org/10.1186/s40729-020-0207-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013).
All the authors consent to publication.
Alessandro Perini, Giada Ferrante, Stefano Sivolella, Joaquín Urbizo Velez, Franco Bengazi, and Daniele Botticelli declare that they have no competing interests.
Correspondence to
Alessandro Perini.
Department of Neuroscience, Division of Dentistry, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
Alessandro Perini, Giada Ferrante & Stefano Sivolella
Faculty of Dentistry, University of Medical Science, Havana, Cuba
Joaquín Urbizo Velez & Franco Bengazi
ARDEC Academy, Ariminum Odontologica, Rimini, Italy
Daniele Botticelli
You can also search for this author in
...
This study was funded by ARDEC Academy, Ariminum Odontologica s.r.l., Rimini, Italy.
Degradable Solutions AG, a Sunstar Group Company, CH-8952 Schlieren ZH, Switzerland, provided free of charge the biomaterials used.
Iida T. Carneiro Martins Neto E, Botticelli D, Apaza Alccayhuaman KA, Lang NP, Xavier SP. Influence of a collagen membrane positioned subjacent the sinus mucosa following the elevation of the maxillary sinus: a histomorphometric study in rabbits. Clin Oral Implants Res. 2017 Dec;28(12):1567–76.
Inal S, Yilmaz N, Nisbet C, Güvenç T. Biochemical and histopathological findings of N-butyl-2-cyano...
Russell WMS, Burch RL. The principles of human experimental technique. London: Methuen; 1959.
Schroeder HE, Münzel-Pedrazzoli S. Correlated morphometric and biochemical analysis of gingival tissue: morphometric model, tissue sampling and test of stereologic procedures. J Microsc. 1973 Dec;99(3):301–29.
Sohn DS, Kim WS, An KM, Song KJ, Lee JM, Mun YS. Comparative histomorphometric analysis of ...
Nosaka Y, Nosaka H, Arai Y. Complications of postoperative swelling of the maxillary sinus membrane after sinus floor augmentation. J Oral Sci Rehab. 2015;1:26–33.
Tawil G, Tawil P, Khairallah A. Sinus floor elevation using the lateral approach and bone window repositioning I: clinical and radiographic results in 102 consecutively treated patients followed from 1 to 5 years. Int J Oral Maxillof...
Tatum H Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler DG, Johnson PW, Lozada JL, Misch C, Rosenlicht JL, Tatum OH Jr., Wagner JR. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36:151–86.
Boyne PJ, James RA. Grafting of the ...
Biphasic calcium phosphate
Deproteinized Bovine Bone Mineral
Hydroxyapatite
Infraorbital nerve canal
Standard deviation
Beta-tricalcium phosphate
All data and materials are available for control and consultation contacting the first author (alexperini@studioschweiger.it).
In conclusion, the repositioning of the bone window after sinus floor elevation in sheep, compared with the use of a resorbable membrane, improved the closure of the antrostomy and led to a greater amount of the newly formed bone in the close-to-window zone of the grafted area. The bone window appeared partially bonded to the newly formed bone. Bridges of new bone from the edges of the antrostomy ...
In the present study, a lesser amount of bone was registered subjacent to the sinus mucosa compared with the other regions. This is in agreement with another experiment, in which a similar material was used for sinus augmentation in sheep [24]. A similar outcome was also reported in another study [27] that used DBBM xenograft for sinus augmentation in sheep. In that study, a collagen membrane was ...
In another similar experiment in sheep, the sinuses were augmented using a similar biphasic calcium phosphate (60% HA, 40% β-TCP) [24], the biomaterial used in the present study. The perforation of the sinus mucosa was performed at the test sites and a collagen membrane was placed to protect the perforation, while at control sites the elevated mucosa was left unprotected. After 12 weeks of heal...
The aim of the present study was to compare the healing of the augmented sinus in large animals, where the antrostomy was covered by a polylactic membrane or a repositioned bone plate, both secured with cyanoacrylate.
No statistically significant differences were found between test and control sites in the bone formation within the augmented space. This outcome is in agreement with a similar stud...
In the centre of the window area, at the test sites, in the analysed histological sections, the bone plate was still visible in five out of six sheep. It appeared partly remodelled and connected by the new bone formed in the sub-window area. Out of the five bone plates still present, three were bridged to the edges of the antrostomy, while in the two cases no contact was achieved in the observed s...
During surgery, one sheep showed acute sinusitis at the test site. The sinus mucosa was perforated to allow sinus drainage and surgery was completed. During the healing period, no evident clinical complications were observed.
At the histomorphometric analysis, one sinus of the control group and one of the test group (corresponding to the sinusitis case) appeared to have lost almost all biomateria...
The percentages of the new mineralised bone, soft or connective tissue, pure graft, graft interpenetrated by bone, and remnants of cyanoacrylate were evaluated. The total tissue percentages in the elevated space that included submucosa, middle, base, and sub-window regions were also calculated.
Mean values and standard deviations (SDs) as well as the 25th, 50th (median), and 75th percentiles were...
After 4 months, the animals were anaesthetised and then euthanised with an overdose of pentobarbital sodium and subsequently perfused with 10% formalin. The maxilla was retrieved en bloc, trimmed, and immersed in formalin solution.
All histological procedures were performed in the Laboratorio de Histologıa de la Facultad de Odontologıa de la Universidad de Ciencia Medica in Havana, Cuba. Bila...
Through an extra-oral approach, an oblique incision was made bilaterally along the sagittal axis between the facial tuberosity and the inferior orbital rim. The skin and periosteum were elevated separately, and the bony facial sinus wall was exposed on both sides of the maxilla (Fig. 1a).
A 12-mm large and 8-mm high antrostomy was prepared using a burr (H254E Komet Dental, Trophagener Weg 25, L...
The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013).
Eight female Pelibuey sheep, with a mean body weight of approximately 35 kg and a mean age of approximately 3 years, were provided by the Centro Nacional para la Producción de Animales de Laboratorio (CENPALAB) in Havana, Cuba...
To prevent the movement of the bony plate and to gain adequate stability, cyanoacrylate has been suggested to glue the plate to the bony edges of the antrostomy [17]. Cyanoacrylates (as methyl 2-cyanoacrylate or ethyl 2-cyanoacrylate) are widely used in surgery and have shown good compatibility [18] and biomechanical strength for fixation of grafts [19]. In an experiment in rabbits [17], the antro...
Sinus floor elevation is a commonly used technique to increase bone volume in the posterior maxilla prior to implant placement. This procedure was first developed by Tatum in 1977 [1], modified by Boyne and James in 1980 [2], and further modified over time. In this well-described technique, a bony window is created on the lateral wall of the sinus with a round burr, and the membrane elevated. Diff...
The objective of this study was to compare the healing of the augmented sinus at which the antrostomy was covered with a membrane or the repositioned bone plate.
Eight sheep underwent bilateral maxillary sinus floor augmentation. The control site was covered with a resorbable membrane, while at the experimental site the bone plate was repositioned, and both were secured with cyanoacrylate. Animal...